NPI | 1447690292 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH 7052) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 7052) |
103TC0700X Psychologist, Clinical (Licence: TX 36206) | |
Enumeration Date | 2013-06-26 |
Last Update Date | 2018-01-31 |